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REACH 2014 Awardees

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Racial and Ethnic Approaches to Community Health (REACH) is a national program administered by the Centers for Disease Control and Prevention (CDC) aimed at reducing racial and ethnic disparities in health. Through REACH 2014, CDC supports awardee partners that will establish community-based programs and culturally-tailored interventions serving African Americans, American Indians, Hispanics/Latinos, Asian Americans, Alaska Natives, and Pacific Islanders.

Interventions focus on proper nutrition, physical activity, tobacco use and exposure, and chronic disease prevention, risk reduction and management opportunities. Additionally, awardees will address health disparities in heart disease, diabetes, and infant health. The intent of REACH is to build an evidence base that supports community-centered approaches to reducing or eliminating health disparities. REACH strategies will impact at least 75% of the selected priority population.

REACH will support two types of awardees:

20 Basic Implementation Awardees identified at least one chronic disease factor that will impact the proposed target population

Project Overview: Asian-American and Pacific Islander communities, especially those who are newly arriving, face major health-related barriers and health disparities. Building on previous community health investments, ASIA will partner with Cleveland’s AsiaTown neighborhood, The Cuyahoga County Board of Health, and other groups to increase access to healthy food options, nutrition education and physical activity opportunities.

Project Overview: In central Virginia, a third of the residents have been diagnosed with high blood pressure. In Charles City County and the City of Richmond that proportion rose to 47% and 45% respectively. In fact, on average, the percentage of African Americans reporting high blood pressure is at least 17% higher than that of the Whites (RMSA, 2013). To address this issue, the Balm In Gilead, in partnership with the Central Virginia Interfaith Coalition and other community organizations, will increase access to physical activity opportunities. The collaborative will support 10 faith‐based organizations who will serve as catalysts to promote physical activity and improve environments for African Americans residing in target Richmond communities.

Project Overview: In Stockton County, California, access to healthy food is limited. Residents have no or low access to healthy foods and beverages, contributing to the area’s high obesity and chronic disease rates. CCPHA will collaborate with the National Association for the Advancement of Colored People Stockton Branch and other local organizations to increase access to healthy food and beverages. They will also work to increase access to breastfeeding accommodations for nursing moms.

Project Overview: CMCH will collaborate with local community organizations to increase access to chronic disease management resources at healthcare organizations, pharmacies, and social service organizations.

Project Overview: While exposure to secondhand smoke is harmful to adults and leads to serious health complications and disease, the effects of exposure to secondhand smoke is particularly dangerous for infants and children. For example, babies are more likely to die from sudden infant death syndrome. The City of Pasadena will work to reduce racial and ethnic health disparities that exist in Northwest Pasadena due to disproportionately high rates of tobacco use and exposure among African-American and Latino populations. The project will implement culturally tailored strategies designed to make healthy living easier where residents live, learn, work, and play. By changing social norms, the default behavior for how people in the community think and act will leave lasting impact in the neighborhood. The project will benefit from the engagement and participation of the multi-sector Pasadena Tobacco Prevention Coalition which will bring unique knowledge of the needs, barriers, and assets of Northwest Pasadena to the project’s public health approach.

Project Overview: Eighty-one percent of African Americans in Colorado eat fewer than five servings of fruits and vegetables and 21% do not engage in any regular physical activity (Colorado Department of Health and Environment Racial and Ethnic Health Disparities in Colorado 2009 report). The CBHC will collaborate with a network of public/private healthcare professionals, providers, and the community to conduct trainings and increase access to health education resources. CBHC and its partners will also target efforts to improve linkages to clinical and community services that help prevent and manage chronic conditions.

Project Overview: In Douglas County, Nebraska, minorities experience above average incidences of death and disability due to chronic diseases. For instance, African Americans exceed the county rate of heart disease, and death from stroke in the African-American community is 1.5 times higher than U.S. rates. Creighton University will partner with the Omaha Housing Authority and other local groups to improve health education, screening, and healthcare referrals for African Americans living in the Omaha area. The project is a partnership that has joined forces with community organizations in Douglas County, Nebraska, to collaborate with churches and the Omaha Housing Authority to develop health standards that promote healthy living where residents live, work, play, and pray.

Project Overview: George Washington University will engage in a community-based participatory model to strengthen an existing community coalition in Langley Park, MD. The project will select, implement, evaluate, and disseminate best practices to address the key risk factors of poor nutrition, resulting in positive changes in obesity, diabetes, and heart disease. The REACH coalition will build on an existing body of work that, incorporates the university, a community partnership, and preliminary work already underway as part of the Center’s relationship with the community and other programs.

Project Overview: ManyAfrican Americans in the Mississippi Delta live in neighborhoods not easily accessible to stores that offer healthy food and beverages. Most of these neighborhoods also lack sidewalks and walking trails. In an effort to address these issues, Greenwood Leflore Hospital will collaborate with local organizations to increase access to chronic disease prevention resources and self-management programs at worksites and in community settings. They will also establish health information technology systems to collect data that can be shared across multiple health care organizations and leveraged for quality improvement and prevention activities.

Project Overview: A recent study of hunger and food insecurity found a greater disparity of poor nutrition among the people living in Kalihi Valley. To address this issue, Kōkua Kalihi Valley Comprehensive Family Services will partner with Parity in Nutrition Access and other local organizations to develop solutions for residents to implement their own food system. They will also increase access to grocery stores with healthy food options within the target location.

Project Overview: Health disparities in the District of Columbia emerge from a wide range of inequalities in income, employment, educational achievement, policy, clinical systems, and food and physical activity environments. To address this issue, LCHC will collaborate with local community organizations to increase access to services that help prevent and manage chronic diseases; establish a health information exchange system that permits effective and efficient delivery of health services; and promote community preventive health resources in underserved, low-income communities in the District of Columbia.

Project Overview: In Alameda County, higher percentages of African Americans report eating fast food three or more times per week. The Mandela Marketplace will partner with the Alameda County Health Care Services Agency, West Oakland Health Council, Oakland Unified School District and other local organizations to strengthen an active coalition of resident‐led food enterprises to improve access to healthy food and beverage options in the target community. The coalition will incentivize new grocery store development, expand mobile produce stands and small stores; and increase the availability and affordability of healthy foods in schools, senior centers and other institutional settings throughout Alameda County.

Project Overview: From 1997-2006, obesity trends in the City of Nashville increased markedly for African Americans (35%-55%).The trend was significantly lower (14%-25%) for the white population during the same period. To address this growing issue, Meharry Medical College and the Nashville Health Disparities Coalition will empower community members in priority population groups to seek better health, help change local healthcare practices, and mobilize communities to implement evidence-based public health programs to reduce health disparities across a broad range of conditions.

Project Overview: Stoughton and Brockton communities share many health-related challenges, including lack of access to environments that offer physical activity opportunities. To address this issue, the Old Colony Healthy Communities Coalition and community partners will increase access to clinical and community resources that help manage chronic diseases impacting African Americans living in Brockton and Stoughton County.

Project Overview: The prevalence of chronic diseases such as diabetes, obesity, hypertension, heart disease, and stomach cancer in Asian communities is a growing concern. Moreover, cancer, heart disease, and diabetes are ranked as the top leading causes of death among Asians. To address these issues, Operation Samahan, Inc. will collaborate with Asian/Pacific Islander American Health Forum, the New York University Center for Studies on Asian-American Health, and other local community organizations to improve access to healthy eating choices at local Asian-owned restaurants. These business owners are encouraged to highlight healthy dishes, modify recipes, offer smaller food portions, and create nutrition labeling.

Project Overview:While 90.9% of San Diegans have access to health insurance, there is marked disparity between Whites (94.5%) and Hispanics (82.1%). Additionally, due primarily to cost, Latinos were the most likely to delay medical services or get needed medicine prescribed by a doctor. PCI will collaborate with local organizations to increase access to community resources that help Hispanic/Latina women prevent and manage their chronic conditions.

Project Overview: African Americans suffer disproportionately from cardiovascular disease in the City of San Diego. For instance, research demonstrates that heart failure is 20 times more likely to occur in African-American men and women in their 30s and 40s, than similarly aged White men and women. Under the REACH program, the University of California-San Diego will collaborate with healthcare facilities and faith-based organizations to improve early identification of individuals with risk factors.

Project Overview: In parts of Denver, physical inactivity is a significant risk factor for the community, particularly among the African-American population. The Denver Behavioral Risk Factor Surveillance System (BRFSS) revealed that 33.9% of African Americans are obese (compared to only 13.5% of white residents), 43.6% of African Americans have high blood pressure, and almost one-quarter (22.2%) admitted they had not participated in physical activity in the last 30 days. To address these issues, the Stapleton Foundation for SFSUC will partner with local organizations to offer safe spaces and places for physical activity. The ultimate goal is to improve quality of life, prevent premature deaths, and reduce medical costs for African Americans living in Montbello and Northeast Park Hill communities.

Project Overview: Asian-Americans (AA) have increasingly encountered unique health risks and health disparities. Recent data indicates that increases in diabetes, hypertension, and coronary heart disease and stroke present new threats to AA health. To address these issues, Temple University will partner with local organizations to increase access to healthy food and beverage options for low-income Asian-Americans living in the greater Philadelphia area.

Project Overview: Poverty, lack of higher education, physical inactivity, poor housing, poor nutrition, and lack of access to health care are core factors leading to racial disparities in health outcomes for Native Americans living in Inyo and Mono Counties. The Toiyabe Indian Health Project will collaborate with local organizations to increase the availability of fresh fruit and vegetables through a focus on expanding service area access to SNAP and WIC beneficiaries and food delivery programs for elders; engage various target populations on how to grow, harvest, prepare, and preserve healthy, traditional Shoshone and Paiute foods; and improve clinical and community linkages to weight management resources for American Indians and Alaska Natives in the target community.

Project Overview: AltaMed Health Services Corporation will collaborate with the Los Angeles Department of Public Health, YMCA, Boys & Girls Club, Volunteers of East Los Angeles, and other local organizations to increase access to healthy foods and physical activity opportunities. The project will help prevent, reduce and manage chronic illnesses. These efforts will focus on low‐income, Latino communities in the designated areas.

Project Overview: Statewide data indicate that diabetes, heart disease and stroke continue to disproportionately plague African Americans, Asians, and Hispanics as compared with Whites. The Asian Media Access, along with other community organizations are set to reach approximately 75% of the priority population using comprehensive culturally-appropriate communication to educate and promote healthy living opportunities for an estimated 26,000 North Minnesota residents.

Project Overview: American Indian/Alaska Native children have a high prevalence of being overweight and obese. The Benewah Medical & Wellness Center and the City of Plumber propose to address these health disparities on the Coeur d’Alene Reservation by increasing access to physical activity, healthy eating and tobacco-free environments.

Project Overview: Vietnamese Americans, especially those who are immigrants, face a high burden of chronic illnesses including stroke, heart disease, diabetes, cancer, chronic lung disease, musculoskeletal disorders and even death. The Boat People SOS-California and local partner organizations will work to increase access to physical activity opportunities and tobacco-free environments which could help to reduce and eliminate health disparities and achieve health equity for Vietnamese residents in Orange County.

Project Overview: Working with the Partners in Health and Housing Coalition, the Boston Public Health Commission will take action to increase access to tobacco-free public housing environments, fruits and vegetables, and physical activity opportunities for the city’s poorest neighborhoods.

Project Overview: Bronx residents suffer disproportionately from chronic diseases including diabetes, hypertension and hyperlipidemia. BCHN will work closely with their coalition to increase access to healthy food options and physical activity opportunities. They will conduct an assessment of current recreational fitness resources for children and adults within south Bronx communities and school settings for children K-12. They will work in collaboration with coalition members representing faith- and community- based organizations, the New York City Department of Education and the New York City Parks Department. They will help increase knowledge, geographic proximity and discounted pricing among individuals living in poverty and who lack transportation to shop outside of their communities to make healthier purchases. As a result of combined efforts, the BCHN will increase access to healthy food and beverage options in South Bronx from 100,000 to 150,000 by September 2017.

Project Overview: South Los Angeles, a predominately African-American and Hispanic community, continues to have poor health outcomes. Inequitable resources dedicated to spaces for physical activity and healthy food access continue to elude this community. To help improve health outcomes, the CCSAPT will partner with the Environmental Prevention Collaborative and others to increase access to resources at local health clinics to help manage chronic illnesses; and build safe, recreational spaces for residents to walk, bike and/or run for physical activity in South LA neighborhoods.

Project Overview: The rate of diabetes deaths in Chula Vista, California (38 deaths per 100,000 people) is significantly higher than the state’s average (19.7 deaths per 100,000 people). This community also has an extremely high rate of coronary heart disease deaths (188.3/100,000) when compared to the state. To overcome these challenges, the Community Health Improvement Partners, will work to increase access to healthy eating and physical activity opportunities at childcare and elementary schools in western Chula Vista neighborhoods. Community Health Improvement Partners will also work with clinical providers to foster other environments that support breastfeeding and healthy nutrition for children within the community.

Project Overview: For many low-income and minority residents across Greater Cleveland, access to healthy food and beverage options, safe environments for physical activity, and clinical preventive services is limited. Additionally, Cleveland adults suffer disproportionately from chronic disease and are less likely to participate in proactive preventive health behaviors than others across the state or nation. The CCDBH will increase access and opportunity for improved nutrition, physical activity and chronic disease management. Partnering with the Health Improvement Partnership of Cuyahoga County, CCDBH will work to increase the availability of healthy food and beverage consumption at small retail stores in the target area; expand agreements with schools, communities, parks and recreation facilities to increase physical activity opportunities; and improve access to high quality care, chronic disease prevention and risk reduction resources. Strategies will be implemented across six Cleveland neighborhoods and one large section of East Cleveland (inner ring suburb), aiming to reach over 40,000 residents of which 92.7% are African American.

Project Overview: When comparing minority health to that of the general population, disparities continue to exist. In Georgia, 46% of African Americans still don’t get enough physical activity. To address this issue and other health disparities, DeKalb County Board of Health will implement evidence based strategies such as creating and implementing a sustainable mobile market (farm stand‐on‐wheels) to distribute locally-produced foods during regularly scheduled stops in low‐income, food‐insecure communities. The awardee will also work with the DeKalb Housing Authority and Cooperative Extension Service to provide decision prompts that promote the purchase of fruits and vegetables; disseminate information to libraries and health centers as a part of a county-wide communication campaign; and establish joint-use agreements with community partners that increase access to opportunities for community residents to participate in physical activity.

Project Overview: A 2014 community health needs assessment, conducted by the Robert Wood Johnson Foundation, ranked Bronx County as the “least healthy” county in New York State. African Americans and Hispanics in South Bronx continue to experience significant barriers to accessing healthy foods and places to exercise. IOFH and community partners will collaborate to increase access to fresh fruit and vegetables at bodegas, restaurants, farm stands and schools. IOFH will also work to increase access to safe spaces for residents to walk, bike and/or run at parks and other built environments in targeted areas.

Priority Population(s): Native Americans of the Saginaw Chippewa Indian Tribe, the Nottawaseppi Band of Huron Potawatomi, the Match-E-Be-Nash-She-Wish Band of Potawatomi, the Little Traverse Bay Bands of Odawa and Chippewa Indians , the Keweenaw Bay Indian Community, the Hannahville Indian Community, the Bay Mills Indian Community and the American Indian Health and Family Services Agency

Project Overview: Native Americans in Michigan experience high rates of chronic disease morbidity and mortality compared to state and national averages. The Inter-Tribal Council of Michigan, Inc. will collaborate with Native American Tribes in Michigan to increase access to physical activity opportunities, healthy food and beverage options, free or low cost tobacco cessation services, and resources to help manage chronic diseases.

Project Overview: Residents living in “Hope Zones,” an underrepresented area of Grand Rapids, Michigan, are more likely to suffer from health risks associated with obesity and chronic disease. Few neighborhood food stores offer healthy food options in these communities. There are few safe, affordable opportunities within the community for physical activity or access to chronic disease prevention, risk reduction, and management opportunities to manage chronic illnesses. To address these issues, Kent County Health Department will partner with the YMCA of Greater Grand Rapids and other local organizations to increase access to healthy foods at corner stores and farmers’ markets; improve safety at existing parks for residents to walk, bike and/or run for physical activity; and protect residents from secondhand smoke exposure in public spaces.

Project Overview: African Americans in the River Region are disproportionately affected by chronic diseases including diabetes and heart disease. The Montgomery Area Community Wellness Coalition (The Wellness Coalition) and the City of Montgomery’s River Region Obesity Task Force will partner to increase access to fruit and vegetables at convenience stores; parks and walking trails for physical activity, and chronic disease self-management education opportunities.

Project Overview: The Morehouse School of Medicine will partner with local organizations to increase access to chronic disease prevention, risk reduction, and management opportunities. Morehouse School of Medicine will work to connect African Americans to healthcare organizations that provide resources to improve access to diabetes prevention and other chronic diseases. They will also increase awareness and access to physical activity and healthy eating options in the target community.

Project Overview: In Multnomah County, African Americans are plagued by health inequities and chronic disease disparities. To address these issues, the Multnomah County Health Department will partner with the city of Gresham, the Urban League of Portland, and other local organizations to increase access to cessation programs, tobacco-free environments and healthy foods at corner stores.

Project Overview: There is a lack of culturally-tailored programs that promote Hypertension or Cardiovascular disease management in Asian American communities. To address this issue, NYUSM will partner with faith-based organizations serving the target audience to increase the availability of low-fat meals, including fruits and vegetables at congregation meetings, corner stores and restaurants. They will also work to improve community connections to clinics’ and hospitals’ resources to help residents manage hypertension and cardiovascular diseases.

Project Overview: Oakland University will collaborate with local organizations to increase access to fresh fruit and vegetables at churches, hospitals, and schools; increase time spent in physical activities at school and afterschool programs from moderate to vigorous; and increase safety and access to local parks for residents to walk, bike and/or run for physical activity.

Project Overview: Over the past two decades, American Indians/Native Americans have had consistent rising rates and greater mortality of obesity, diabetes, cardiovascular disease and stroke. To address these issues, Partners in Health will collaborate with Community Outreach and Patient Empowerment to increase access to fruits and vegetables sold in local, small stores. PIH will also increase access to clinical and community preventive resources that support breastfeeding and help reduce risk of cardiovascular disease for American Indians and Alaska Natives in rural Navajo Nation communities.

Project Overview: Presbyterian Healthcare Services will partner with the community to address health disparities in two populations of Bernalillo County of Albuquerque, New Mexico: the Hispanic and the American Indian population. Together these two groups represent a priority population of 55,456 people. This project will focus on the risk factors of poor nutrition, physical inactivity, and lack of access to chronic disease prevention, risk reduction and management opportunities.

The comprehensive plan will:

Increase access points for fresh, local produce, educate on its nutritional value, and make produce more affordable for low income individuals;

Improve awareness and opportunities for physical activities-especially building infrastructure to increase walking options; and

Project Overview: Kannapolis and Concord make up the majority of food insecure areas in Cabarrus County. Minorities in Cabarrus County experience significantly worse health outcomes. For example, the rate of heart disease mortality among African Americans in Cabarrus County was 15% higher than whites among males and 25% higher than whites among females. The Public Health Authority of Cabarrus County will partner with Healthy Cabarrus and other local organizations to increase access to healthy foods at corner stores, schools, parks, and other community agencies; they will also work to improve community designs, and establish agreements with schools and churches to use their facilities after hours for physical activity.

Geographic Location(s) of Work: City of Oakland in San Joaquin County (northern, central and southern Valley of San Joaquin), California

Award Amount: $977,400

Priority Population(s): Hispanics living in Turlock, Cere; the southeast neighborhood of Fresno, Orange Cove; the southeast or Greenfield neighborhood of Bakersfield; and Arvin in San Joaquin, California

Project Overview: The Public Health Institute will partner with local organizations to increase affordable, healthy food options in corner stores, restaurants, farmers’ markets, schools, farm stands, community gardens, roadside vendors, vending machines and food trucks. The Public Health Institute will also work to offer physical activity opportunities at school gyms after school hours and on weekends.

Project Overview: People spend approximately 68% of their time at home and for those who live in multi‐unit housing (MUH), many have little control over the air they breathe. The UCLA Center of Health Policy Research in partnership with Smoke Free Air For Everyone (S.A.F.E.), CD Tech Community Development Corporation, the Apartment Association of Greater Los Angeles, Los Angeles County Department of Public Health, and other community organizations will utilize the already popular initiative of eliminating secondhand smoke exposure in public spaces and worksites by focusing this effort on rental housing for single and multi-unit residences. A multi-sector coalition consisting of representatives from universities, community developments, apartment associations, school districts, and non-profit organizations will engage tenants and owners of multi‐unit housing in low income Latino and African-American communities to reduce secondhand smoke exposure and increase access to smoking cessation services for tenants who smoke.

Project Overview: More than 20% of adults in San Francisco are diagnosed with high blood pressure. This percentage is more than double among African Americans. To address this issue and other health disparities, the San Francisco Department of Public Health will collaborate with the San Francisco Health Improvement Partnership (SFHIP) to educate and offer resources at hospitals and clinics on managing hypertension and cardiovascular diseases.

Project Overview: African Americans in Birmingham carry a disproportionate disease burden, with higher than average rates of morbidity and mortality attributable to obesity. Life expectancy in Jefferson County varies 20 years across census tracks due to socioeconomic and environmental factors that influence health. Building on previous community health investments, a multi-sector coalition will increase nutrition and physical activity opportunities for African Americans within Birmingham, Alabama. The University of Alabama at Birmingham (UAB) Minority Health and Health Disparities Research Center at the Division of Preventive Medicine in partnership with Jefferson County Department of Health, the United Way of Central Alabama, Safe Routes to School, and other community organizations are taking steps to increase access to affordable, locally-grown fruits and vegetables at farmers’ markets and increase access to physical activity opportunities by implementing Safe Routes to School programs and improving community designs.

Project Overview: Hispanic and Marshallese communities in Northwest Arkansas continue to experience chronic disease disparities, due to lack of access to healthy foods and culturally and linguistically appropriate healthcare services. To address these issues, the University of Arkansas for Medical Sciences, Arkansas Department of Health, Feed Communities, Endeavor Foundation, and others will take action to increase access to chronic disease prevention services and self-management programs at worksites and faith-based organizations. The University of Arkansas for Medical Sciences and others will also increase the availability of affordable fruits and vegetables at food pantries, community gardens, worksites and schools.

Priority Population(s): Pacific Islanders in three freely associated states -- Republic of the Marshall Islands; Federated States of Micronesia: Chuuk, Kosrae, Pohnpei, and Yap; the Republic of Palau; two US territories: American Samoa and Guam; and the Commonwealth of the Northern Mariana Islands

Project Overview: The University of Hawaii will partner with the Cancer Council of the Pacific Islands (CCPI) and other local organizations to increase access to healthy food and beverage options at local worksites, businesses, health care settings and tobacco-free environments.

Project Overview: Hispanics are 1.7 times more likely to be diagnosed with diabetes compared to non‐Hispanic/Whites (Centers for Disease Control and Prevention, 2014), and they are 2 to 4 times more likely to experience cardiovascular disease (Cusi & Ocampo, 2011). The University of Kansas Center for Research, Inc., in collaboration with, Latino Health for All Coalition will increase access to healthy foods at restaurants, corner stores, concession stands and vending machines. The collaborative effort will also implement community design improvements that encourage walking, biking or running for physical activity.

Project Overview:YMCA of Greater Cleveland will partner with local organizations to transform unsafe urban thoroughfares into safe and convenient resources which encourage physical activity. This builds on the previously awarded REACH project of 2003, Clevelanders in Motion Health Equity Coalition.